Petterson Timothy, Lyon Lindsay, Peckler Bradley
Department of Emergency Medicine, Wellington Hospital, Wellington, New Zealand.
J Emerg Trauma Shock. 2013 Jul;6(3):227-9. doi: 10.4103/0974-2700.115356.
A 51-year-old woman was brought into the Emergency Department (ED) following an intentional overdose of alcohol and her medication. Along with two bottles of wine it was estimated that she had taken 5800 mg of Quetiapine and 240 mg of Citalopram along with the wine. The ambient temperature in her flat was thought to be 10°C. On arrival to the ED her GCS was 8. She had agonal respirations with a pulse of 56/min, hypotensive 55/35 mmHg and a temperature 24°C. The patient was intubated and was given sodium bicarbonate, magnesium sulphate, calcium gluconate and an adrenaline infusion. She received active and passive rewarming measures. She had significant ECG findings related to her hypothermia and polypharmacy overdose which seemed to have been cumulative. The patient recovered and the only neurological deficit was numbness in her left leg which was thought to be related to prolonged immobility. Hypothermia may have contributed to her good outcome as hypothermia has been shown to improve both cardiac and neurological outcome.
一名51岁女性因故意过量饮酒及服用药物后被送往急诊科。据估计，除了两瓶葡萄酒外，她还服用了5800毫克喹硫平和240毫克西酞普兰。据认为她公寓内的环境温度为10°C。到达急诊科时，她的格拉斯哥昏迷评分（GCS）为8分。她有濒死呼吸，脉搏56次/分钟，血压低至55/35 mmHg，体温24°C。患者接受了气管插管，并给予了碳酸氢钠、硫酸镁、葡萄糖酸钙和肾上腺素输注。她接受了主动和被动复温措施。她有与体温过低和多种药物过量相关的显著心电图表现，这些表现似乎具有累积性。患者康复，唯一的神经功能缺损是左腿麻木，这被认为与长时间不动有关。体温过低可能促成了她良好的预后，因为已表明体温过低可改善心脏和神经方面的预后。
